ENT Flashcards
Presbycusis (age related hearing loss) Fx
bilateral high frequency hearing loss
Acoustic neuroma Fx
unilateral hearing loss, vertigo, nausea
Acoustic neuroma Ix
MRI Head
auditory brainstem response testing
Cholesteatoma Fx
unilateral hearing loss
otoscopy - pearly white lump in attic of tympanic membrane
Conductive hearing loss
Osteoma Fx
rare
unilateral ear pain followed by unilateral hearing loss
common in cold water swimmers
Epistaxis Mx
1st - first aid 20minutes - squeeze nostrils
2nd - topical adrenaline/local anaesthetic/ topical tranexamic acid
3. nasal packing .
4. surgical intervention (sphenopalatine artery ligation).
Otitis externa Mx
1st - topical antibiotic + topical steroid
2nd - PO Abx + Antifungal + ENT
Malignant otitis externa
Fx
Ix
immunocompromised patient (esp diabetes)
commonly pseudomonas aeruginosa
Ix - CT scan
malignant otits externa Mx
IV Abx (Ciprofloxacin)
ENT urgent
malignant otits externa Mx
IV Abx (Ciprofloxacin)
ENT urgent
Otosclerosis Fx
autosomal dominant
20-40 yr olds
tinnitus and conductive hearing loss
Meniere’s Fx
vertigo
tinnitus
sensorineural hearing loss
Perforated tympanic membrane (ear drum) Mx
majority self resolve within 6-8 weeks
give Abx if associated otitis media
ENT referral if not healed by 6 weeks for myringoplasty
2 week wait for ENT/ oral Ca indications (6)
- oral ulcer >3 weeks
- red/ white patches that bleed/ painful
- earache (+head/neck pain) > 4weeks with normal otoscopy
- neck lump changed over 3 weeks
- persistent sore or painful throat
- oral cavity >6 weeks
tonsillitis Mx
phenoxymethylpennicillin
erythromycin (if pen allergy)
conductive hearing loss Rinne and weber explained
1st - if bone > air = conductive hearing loss
2nd - webers will be heard loudest on the same side of the bone>air ear = conductive
conductive hearing loss causes
Impacted wax
Inner ear effusion
Debris/foreign body in ear canal
Perforated ear drum
Otosclerosis
sensorineural hearing loss rinne and weber explained
1st - rinne air > bone ALWAYS
2nd - weber is heard loudest on OPPOSITE ear (eg if left is loudest, therefore right ear sensorineural loss)
menierres Mx
ENT referral OP
contact dvla - stop driving until symptoms under control
acute attack - buccal/ IM prochlorperazine
prevention - betahistine/ vestibular rehab
red flag symptoms of chronic rhinosinusitis (3)
unilateral
persistent despite 3 months of treatment
epistaxis
chronic rhinosinusitis Mx
intranasal steroid
nasal irrigation with saline
2 week wait laryngeal Ca
> 45 yo
persistent hoarse throat
neck lump
sore throat >4 week
BPPV
Ix
Mx
Ix - Dix Hallpike
Mx - epley
Bullous myringitis Fx
painful vesicles on tympanic membrane
Unilateral nasal obstruction
Unilatwr epistaxis without trauma
? Cause
Nasopharyngeal ca
